Beverly Zidor, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN015283 Issued in GA

Practice address

3509 Baker Road Suite 401
Acworth, GA 30101-3010

Phone

(770) 917-8943

Fax

(770) 917-8943

NPI assigned

Jun 17, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Smiles Buford Center LLC

  • Dentist
  • Buford, GA
  • NPI 1740984574
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992144554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 BAKER ROAD SUITE 401",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "30101",
            "telephone_number": "770-917-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 BAKER ROAD SUITE 401",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301013010",
            "telephone_number": "770-917-8943",
            "fax_number": "770-917-8943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1721 Powder Springs Rd SW Ste 103",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300644880",
            "country_code": "US",
            "telephone_number": "770-293-0605",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "219 Front St",
            "address_purpose": "LOCATION",
            "city": "Binghamton",
            "state": "NY",
            "postal_code": "139052455",
            "country_code": "US",
            "telephone_number": "772-828-9005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIDOR",
        "first_name": "BEVERLY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057730",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mitchell Evan Zaplatosch, PHD, RD
• Annika Zenn
• Henry John Zielinski, M.D.
• Sarah Zipfel, MA, LPC

• General Practice Dentistry in Acworth, GA
• Providers in Acworth, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.